Healthy Choice Enterprise, Inc.

HCE Programs » Health Wellness Event Packages » HCE Forms and Agreements

Event Preparation Questionnaire and Agreement

        Educating, encouraging and empowering your attendees to lead active,            

                  healthy lifestyles is what we do best. Because our programs

                           are targeted to your population, You get results!

To make your program a success we need preparation information. Please submit information 6 months and no later than 6 weeks before your expected event date, to allow adequate preparation. Include any programs your company is running so that they may be included in the Event. This form can be downloaded, printed and mailed if preferred. 



Contact Person: __________________________________________
Additional Contact Person __________________________________
Human Resources ________________________________________
Insurance Benefits Department ______________________________
Health Plan _____________________________________________
Dental Plan _____________________________________________
Vision Plan ______________________________________________
Wellness Program ________________________________________
Child Care resources ______________________________________
Employee Assistance Programs ______________________________
Occupational Health_______________________________________
Other Personnel ___________________________________________

What is your company's main wellness goal?
                (check all that apply)
___ Save money
_____ Provide a benefit to employees
_____ Make healthcare more convenient for employees
_____ Keep employees healthy
_____ Don't know

Ongoing Employee Health and Wellness Program Interests
             (Indicate Daily, Weekly, Monthly, Quarterly, Annually)

_____ Wellness Program Consulting
_____ Health Risk Assessments
_____ Employee Health Screening / Bio-metric Testing

Ongoing Employee Health and Wellness Program Interests
             (Indicate Daily, Weekly, Monthly, Quarterly, Annually)

_____ Health Coaching / Wellness Coaching
_____ Health Fairs / Wellness Fairs
_____ Wellness Workshops / Lunch and Learns
_____ Wellness Challenges / Wellness Competitions
_____ Incentive Programs / Points Based Tracking
_____ Gym Discounts
_____ Fitness Center Management
_____ Wellness Newsletters / Self Care / Handouts
_____ Flu Shots
_____ Employee Assistance Programs
_____ Disease Management Programs
_____ Behavior Modification (stress management, smoking
                cessation, etc
_____ Onsite Medical Staffing
_____ Health Promotion Staffing

What is your company's wellness program goal?
______________________________________________________________________________________________________________________________________________________________________________________________________________________________
__________________________________________________________________________

                                                                     Yes         No
Ongoing Wellness Program                     ____            ____
Maintained Daily Onsite by HCE           ____            ____
Quarterly Wellness Events                       ____            ____
Monthly Wellness Events                          ____             ____
Weekly Wellness Events                           ____             ____

Does your Company provide?                 Yes               No
Exercise Area/ Program                            ____            ____
Employee Cafeteria                                   ____           ____
Employee Break Room                             ____            ____
Employee Smoking area                           ____            ____
New Mother Lactation Room                  ____           ____

  Weekly. Monthly. Quarterly. Site Presentations (Check the frequency of exhibition per area listed)


Activities                             Daily            Weekly           Monthly        Quarterly       Annually
Fairs and Events
Wellness Fairs
Health Screenings
Behavior Change
Programs
Weight Management
BMI Assessment

Movement Sessions         Daily            Weekly            Monthly        Quarterly       Annually
Dance Exercise
15-30 min Exercise
Stretching and
Relaxation
Session

Education Information    Daily    Weekly   Monthly  Quarterly  Annually
Web Health Education
Health Promotion
Seminars
30 min Lunch N Learn
Regular Testing

Activities                                Quarterly         Annually____________
Flu Shots
Blood Pressure Tests
Glucose Screenings
Cholesterol
Screenings

Your Health/ Wellness Program starts with your Topic (Review the Health/ Wellness themes): ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

How many people do you expect? _________
Is your event open to the public ___________
Open to your participants only ____________

Your Health/Wellness Fair will includes a choice of one of the seven health fair themes:

General Health,
Heart Health,
Mind & Body,
Fitness,
Nutrition,
Manage-Your-Health,
Safety

A three (3) hour event,  A dedicated account manager responsible for coordinating and implementing all deliverables, Tablecloths, Table signs, posters, and/or banners, Raffle prize valued at $50 (min), Educational handout(s) at each booth, A health fair evaluation and event summary report.

Health Fair Additions
Health Education Topic/s delivered by Speaker/s (additional fees may apply) ______________________________________________________________________________________________________________________________________________________________________________________________________________________________

Specialized Screenings and Tests (additional fees apply) ____________________________________________________________________________________________________________________________________________________

Customization's: What are your special needs at your event? ______________________________________________________________________________________________________________________________________________________________________________________________________________________________

How much space/ room size is allowed for the event? ____________________________________________________________________________________________________________________________________________________

Are you able to provide tables for exhibitors? ____________________________________________________________________________________________________________________________________________________

Special Requests for Electricity (available): Yes______ No______
Need exhibitors to be along a wall only Yes________ No_______
Need the area to be quiet? Yes______ No_________
Are there any exhibitors or companies that you have worked with in the past that you want to include at your event? ______________________________________________________________________________________________________________________________________________________________________________________________________________________________

Do you provide audio/visual equipment, extension cords, 3-pronged adapters, etc. ____________________________________________________________________________________________________________________________________________________

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I have filled out this application to Contract with Healthy Choice Enterprise, Inc for a Health Fair/ Wellness Fair Service. I understand and agree to abide by the rules and regulations outlined in the agreement. I understand that I will not be entitled to a refund in the event of my cancellation or non-compliance with HCE rules and regulations. Signature of person accepting responsibility for registration.

Contract Signature ______________________________
(Your Signature denotes that you have reviewed and agree with the Rules and Regulations)

Date ________________________________________
Deposit ______________________________________

Method of Payment to Healthy Choice Enterprise, Inc.:
 Check____   Cash____   Pay Pal______
If you choose to use Pay Pal and don't have a Pay Pal account, let us know, you can still use the service. All applications are subject to approval by the Healthy Choice Enterprise, Inc. (HCE) Health and Wellness Events company. Please remit the completed event agreement form via mail or email and payments to:

Healthy Choice Enterprise, Inc. 
6701 Del Rey Ave, Ste. 129
Las Vegas, NV. 89146
702- 673- 0302
info@HealthyChoiceEnterprise.com or  HCEntInc@gmail.com
HealthyChoiceEnterprise.com

                       RULES AND REGULATIONS FOR HCE HEALTH AND WELLNESS EVENTS

/HCE Health and Wellness Events occurs rain or shine. There are no refunds in the event of inclement weather, natural disasters, or the facility becoming unavailable beyond the control of HCE. In circumstances beyond control of the Client, HCE will work with the client to reschedule the event.
Set up time will begin 1 hour before event time (Vendors/Exhibitors) will contact us if more time is needed for set up).
/The HCE Health and Wellness Event reserves the right to cease Vendors/Exhibitors privileges at any time. 

NO vulgarity or insulting behavior from clients, exhibitors, or vendors will be tolerated at the HCE Health and Wellness Event. Violation of this rule will result in the removal of the Vendors/Exhibitors. Client Event agreement will be voided. Please do everything to amicably work out any issues that arise between the Exhibitors/ Vendors and the consumers or other Vendors/Exhibitors. We will intercede if we are notified.

/The goal is to present a united front and remain customer service friendly at all times. 

/No Smoking including Tobacco, Vapor or E-cigarettes. 

/No explicit merchandise can or will be exhibited. 

/Prior to the event start, HCE can review any merchandise, and request removal of merchandise that is questionable or merchandise that is not listed in the Exhibitors/Vendors agreement including previously agreed upon merchandise. 

/Vendors/Exhibitors must use the space that is designated by HCE and provided by the Client. If electrical access is provided (based on availability from the client); Vendors/Exhibitors must supply their own extension cords. 

/All Vendors/Exhibitors are responsible for the set-up and breakdown of their own merchandise. NO staff or security will be provided to any Vendors/Exhibitors. Client will provide a safe environment for the execution of the Health/ Wellness Event.
/Vendors/Exhibitors will bring their own change if needed.
/All Vendors/Exhibitors are encouraged to remain at their location or have someone physically present to cover for them, during Vending/Exhibiting Hours. Neither HCE nor the Client assumes responsibility nor liability for Vendors/Exhibitors merchandise or services. 

/NO selling or distribution of food or beverages of any kind are permitted unless contracted. 

/HCE nor the Client offer guarantee of sales or income to any Exhibitor or Vendor. During the event HCE will make frequent announcements to encourage guests to patronize the Vendors/Exhibitors. 

Announcements or Flyers can be sent to HCE prior to the event that will be placed in the swag bags (if available). 

/Clients, please make announcements to help spread the word of your event, the more people who know about it the better the participation. Contact us for internet and flyer advertisements. 

******************************************************************************

I have read all the rules and regulations in the Health and Wellness Events Agreement form pertaining to contracting HCE Health and Wellness Events. I agree to abide by the rules and regulations stated in this registration packet. Violation of any of these rules set forth by HCE Health and Wellness Event will result in termination of the agreement without a refund. My above signature acknowledges that I received this disclosure. Contact us with any questions or concerns regarding your employee’s program. We’ve created a fun and educational event for your organization that will show your people how much you care and create win-win results for you and them! 



Contact us with any questions or concerns regarding your organization's program. We'll created a fun and educational event for you that will show your people how much you care and create win-win results for you and them!

Your deposit is due with your agreement, payable to Healthy Choice Enterprise, Inc. After your information and deposit are received  we will give you a customized event package including a schedule of presenters and vendors with a detailed cost listing within 72 hours. Please contact us for pick up or mailing instructions.

Once we have your information, we can give you a customized event package including a schedule of presenters and vendors with a detailed cost listing. Your program balance will be due is due upon presentation of your completed program details, approximately 72 hours. Please contact us for pick up or mailing instructions. We look forward to working with you and your company and expect an exciting event. We will work hard for you and promise that you will be pleased.

Zakeeyaw Toney, RN
HCE Executive Director  
6701 Del Rey Ave, Ste. 129
Las Vegas, NV. 89146
702- 673- 0302
Info@HealthyChoiceEnterprise.com or HCEntInc@gmail.com
HealthyChoiceEnterprise.com

______________________________________________________________________________________________________________

HCE Health and Wellness Event and Event Evaluation Forms

Name_________________________________________________________________________________________

Phone Number or Email_________________________________________________________________________

Please rate the following aspects of the event:       Excellent        Good           Fair           Poor       N/A  


Attendance____________________________________

Pre- planning__________________________________

Management___________________________________

Quality of Exhibitors/ Vendors____________________

Lay out of booth________________________________

Booth space____________________________________

Publicity_______________________________________

Would you contract HCE for another event again? 

Yes (Why)_______________________________________

No (Why) _______________________________________

Please estimate the number of participants ___________

Did the Theme hit the market you targeted? __________

________________________________________________


Comments on Tables or Booths ______________________________________________________________________________________________________________________________________________________________________________________________


Comments on Speaker/s ______________________________________________________________________________________________________________________________________________________________________________________________ 

Additional Comments or Suggestions:___________________________________________________________________________________________________________________________________________________________________________________



Thank You for your input, we look forward to your evaluation.


Z Toney,

HCE.

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